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Summer 2010 | Vol 13 No 4

Research update

Mark de la Hey

Pressure keeps substance-using pregnant women in treatment

External pressure can increase the likelihood that substance-using pregnant women will remain in treatment, according to a study from Wayne State University in Detroit, Michigan. Researchers looked at data on 200 women from a National Institute on Drug Abuse clinical trials study who were receiving community-based substance abuse treatment. The women were asked whether they had been pressured to attend treatment under threat of jail terms, having their children removed from them, or losing their housing. Thirty-six participants reported being pressured to enter treatment, while 164 were not pressured. Of those who reported coercion, 44 per cent faced legal pressure; 17 per cent were pressured regarding their housing; 36 per cent reported pressure from child protection services; and three per cent were pressured by both legal and housing authorities. The researchers found that those in the coerced group attended an average of 71 days of treatment before dropping out, compared with 46 days for the non-coerced group. The coerced group also had fewer drug-positive urine tests at baseline (29% vs. 40%), during treatment (15% vs. 29%) and at three-month follow-up (18% vs. 27%) compared with the non-coerced group. Although the reduction and prevention of drug use during pregnancy is an important goal, the authors caution that “the use of external pressure could lead to avoidance of health care settings or could inhibit disclosure of substance use among those who do seek care.”

Drug and Alcohol Dependence, March 1, 2010, v. 107 (2-3): 149–153. Steven J. Ondersma et al., Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan.